- 期刊
以急性週邊型顏面神經麻痺為初始表徵之急性下橋腦梗塞
Acute Peripheral-type Facial Palsy as an Initial Presentation of Acute Caudal Pontine Infarction
摘要
貝爾氏麻痺是一種原因不明的急性週邊型顏面神經麻痺，是造成顏面神經麻痺最常見的原因。一47歲男性，有高血壓、第二型糖尿病及慢性腎臟病等過去病史，因突發左側週邊型顏面神經麻痺（House-Brackmann分級第4級），在1日內求診，因無其他神經學病症，診斷為左側貝爾氏麻痺，但2日後開始出現左側顏面及右側軀幹感覺減弱。磁振造影顯示左側下橋腦有急性梗塞，美國國家衛生研究院中風評量表（NIHSS）評為4分。經過2個月的追蹤，左側顏面神經麻痺的狀況依舊。因此，在診斷為貝爾氏麻痺後，仍須注意是否有其他細微的神經學徵候出現，設法排除腦幹中風的可能性。
並列摘要
Bell's palsy is acute peripheral-type facial palsy of unknown etiology, which is contributed to most facial palsies. A 47-year-old man with hypertension, type II diabetic mellitus and chronic renal disease, presented with acute onset of left peripheral-type facial palsy (House-Brackmann classification IV) less than one day. Because of no neurologic focal sign, he was diagnosed with left Bell's palsy. However, hypoesthesia of left face and right trunk occurred 2 days later. Magnetic resonance imaging demonstrated an acute infarction at left caudal pons. The National Institutes of Health Stroke Scale (NIHSS) was 4 scores. The left facial palsy did not relieve over the following 2 months. Therefore, a delicate neurologic focal sign should be followed in order to exclude the possibility of brainstem infarction despite that Bell's palsy has been confirmed.
延伸閱讀
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